Massachusetts General Laws
Chapter 176b - Medical Service Corporations
Section 3 - By-Laws; Joint Service Contracts; Preferred Provider Arrangements

Section 3. The by-laws of a medical service corporation may contain any lawful provisions approved by the commissioner, and shall provide that a majority of the incorporators or members of the corporation and a majority of the directors shall at all times be persons who are not providers of health services licensed under the laws of the commonwealth and that a majority of the directors shall at all times be persons who are or agree to become subscribers to the nonprofit medical service plan. The by-laws of such a corporation may define the qualifications of those persons eligible to become subscribers as provided in section five. Any such corporation may adopt such rules and regulations as may be consistent with the provisions of this chapter. Such rules and regulations and any changes or amendments thereto shall be filed with the commissioner thirty days before their effective dates and shall be subject to subsequent disapproval by the commissioner.
Any medical service corporation may contract with a corporation formed under chapter one hundred and seventy-six A for the joint or co-operative administration of their affairs and for the joint or co-operative writing and issuing of subscription certificates, and shall contract with a corporation formed under chapter one hundred and seventy-six A for the joint or cooperative administration of their affairs when acting as a carrier under chapter one hundred and seventy-six G.
Any medical service corporation may join with any other medical service corporation organized either under the laws of the commonwealth or of any other state for the purpose of establishing or maintaining an agency or corporation designed to facilitate the provision of medical service for residents of the commonwealth employed by firms having employees located in more than one state and may enter into contracts with such an agency or corporation or with a corporation owned by such an agency or corporation for the joint administration of their business and for the joint and cooperative writing and issuing of certificates, provided that any corporation or agency which is not a nonprofit medical service corporation with which there is joint and cooperative writing and issuing of certificates shall be qualified to do business in the commonwealth.
Any medical service corporation may contract with any agency of the United States of America, of the commonwealth or of any city or town within the commonwealth or with any corporation organized under general or special laws for any of the purposes mentioned in chapter one hundred and eighty for the purpose of providing medical service or other health services or reimbursement for such medical service or other health services.
Any medical service corporation which contracts with any agency of the United States of America to provide benefits under Title XVIII of the Social Security Act shall require that a practitioner who participates in said program shall post, in a conspicuous place, his policy regarding the acceptance of medicare assignment, and also require that said practitioner shall inform all eligible persons of his policy regarding medicare assignment prior to the delivery of care and services.
Other provisions of this chapter and chapter one hundred and seventy-six G notwithstanding, any medical service corporation, either individually or by contract with a corporation formed under chapter one hundred and seventy-six A, one or more hospitals licensed under chapter one hundred and eleven, one or more health maintenance organizations under chapter one hundred and seventy-six G, physicians registered under chapter one hundred and twelve and other providers of health care licensed or registered pursuant to chapter one hundred and eleven and chapter one hundred and twelve or one or more insurance companies licensed under chapter one hundred and seventy-five, may establish, maintain, operate, own or offer plans, programs or arrangements which have been approved by the commissioner under said chapter one hundred and seventy-six I.
A medical service corporation shall not condition its willingness to allow any physician or other provider of health services to participate in a preferred provider arrangement on such physician's or provider's agreeing to enter into other contracts or arrangements with the medical service corporation or any other persons that are not part of or related to such preferred provider arrangement.
The terms and conditions offered by a medical service corporation that must be met or agreed to by physicians and other providers of health services desiring to enter into a preferred provider arrangement or plan shall be fair and reasonable. No physician or other provider of health services willing to meet the reasonable terms and conditions proposed or offered in connection with such preferred arrangements shall be denied the opportunity to offer to enter into an agreement with such medical service corporation. The terms and conditions offered by a medical service corporation that must be met or agreed to by physicians and other providers of health services desiring to enter into such agreements shall be subject to the disapproval of the commissioner.

Structure Massachusetts General Laws

Massachusetts General Laws

Part I - Administration of the Government

Title XXII - Corporations

Chapter 176b - Medical Service Corporations

Section 1 - Definitions

Section 2 - Incorporators; Formation; Articles of Organization; Certification

Section 3 - By-Laws; Joint Service Contracts; Preferred Provider Arrangements

Section 3a - Contracts of Reinsurance

Section 3b - Group Medical Service Agreements; Contribution Percentages

Section 4 - Contracts for Medical, Chiropractic, Visual, Surgical, and Other Health Services; Approval, Subscription Certificates; Classification of Risks

Section 4a - Mental Illness Expenses; Inclusion as Benefits; Biologically-Based Mental Disorders; Rape-Related Mental Disorders; Non-Biologically-Based Mental Disorders of Children and Adolescents Under Age 19

Section 4c - Dependent Coverage for Newborn Infants or Adoptive Children; Inclusion of Medical Expenses as Benefits

Section 4d - Refusal to Contract With Blind or Deaf Persons; Prohibition

Section 4e - Diethylstilbestrol Exposure; Discrimination

Section 4f - Cardiac Rehabilitation Expense Benefits

Section 4g - Certified Nurse Midwife Services Benefits

Section 4h - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care

Section 4i - Cytologic Screening and Mammographic Examination Benefits

Section 4j - Infertility Diagnosis and Treatment Benefits

Section 4k - Nonprescription Enteral Formulas for Home Use

Section 4l - Chiropractic Services Benefits

Section 4m - Standardized Claim Form

Section 4n - Off-Label Drug Use; Cancer

Section 4o - Medical Service Agreement Coverage for Bone Marrow Transplants

Section 4p - Off-Label Use of Prescription Drugs for HIV/AIDS Treatment

Section 4q - Coverage for Licensed Hospice Services

Section 4r - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment

Section 4s - Items Medically Necessary for Diagnosis and Treatment of Diabetes

Section 4t - Subscription Certificate Benefits for Services Rendered by a Nurse Anesthetist or Nurse Practitioner

Section 4u - Emergency Services Provided to Insureds for Emergency Medical Conditions

Section 4v - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing

Section 4w - Outpatient Services; Hormone Replacement Therapy for Peri and Post Menopausal Women; Contraceptive Services; Approved Prescription Contraceptive Drugs or Devises; Exception

Section 4x - Coverage for Patient Care Services Provided Under Qualified Clinical Trials

Section 4y - Coverage for Speech, Hearing and Language Disorders

Section 4aa - Coverage for Prosthetic Devices and Repairs

Section 4bb - Coverage for Eligible Dependents Under 26 Years of Age

Section 4cc - Coverage for Medically Necessary Hypodermic Syringes or Needles

Section 4dd - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder

Section 4ee - Coverage for Children 21 Years of Age or Younger for Hearing AIDS and Related Services

Section 4ff - Coverage for Orally Administered Anticancer Medications

Section 4gg - Coverage for Abuse Deterrent Opioid Drug Products

Section 4hh - Preauthorization for Substance Abuse Treatment Not to Be Required

Section 4ii - Coverage for Medically Necessary Acute Treatment or Clinical Stabilization Services

Section 4jj - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease

Section 4kk - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome

Section 4ll - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity

Section 4mm - Pain Management Access Plans

Section 4nn - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products

Section 4oo - Coverage for Treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome

Section 4pp - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs

Section 4qq - Coverage for Prescription Eye Drops

Section 5 - Subscribers; Qualifications, Misrepresentation; Open Enrollment Periods

Section 5a - Discrimination Against Abuse Victims in Terms of Medical Service Plans

Section 5b - Medical Service Plans; Genetic Tests; Discrimination Based on Genetic Information

Section 6 - Subscription Certificate; Issuance; Content

Section 6a - Limited Extension of Benefits

Section 6b - Divorced or Separated Spouses; Continuation of Eligibility for Benefits

Section 7 - Contracts Between Corporation and Care Providers

Section 7a - Medicare Supplemental Group Coverage; Eligibility Due to Age or Disability

Section 7b - Medicare Supplemental Group Coverage; Medical Assistance Recipients

Section 7c - Retroactive Premium Rate Increase

Section 7d - Retroactive Claims Denial for Behavioral Health Services

Section 8 - Annual Statement; Verification, Form, Violations

Section 8a - Financial Statements; Inclusion of Electronic Data Processing Equipment as Asset

Section 8b - Applicability of Chapter 176v to Medical Service Corporations Governed by This Chapter

Section 8c - Applicability of Chapter 176w to Medical Service Corporations Governed by This Chapter

Section 9 - Inspection and Examination of Affairs of Corporation; Confidentiality and Privilege; Inability to Pay Providers; Pro Rata Payments; Termination of Contract

Section 10 - Investments, Sales, Loans and Places of Deposit; Approval; Acquisition of Real Estate; Leases; Tax Exemption; Limit; Special Contingent Surplus

Section 11 - Salaries, Compensation or Emoluments

Section 12 - Submission of Disputes or Controversies to Board; Privacy of Patient Information

Section 13 - Grounds for Enjoining Transaction of Business; Receivers

Section 14 - Liability of Corporation; Exemption From Insurance Laws; Tax Exemption

Section 16 - Operators of Medical Service Plan

Section 16a - Payroll Deductions of Governmental Employees

Section 17 - Enforcement

Section 18 - Contracts for Administrative or Other Services; Loans and Investments

Section 19 - Payment of Sums Owed Subscriber's Estate

Section 20 - Disclosure of Information; Mental or Nervous Condition

Section 21 - Insolvency of Health Maintenance Organization; Replacement Coverage

Section 22 - Statement Provided to Individuals Provided With Creditable Coverage; Report

Section 23 - Attribution of Members to a Primary Care Provider

Section 24 - Disclosure of Patient-Level Data and Contracted Prices of Individual Health Care Services by Carriers to Providers

Section 25 - Coverage for Health Care Services Delivered via Telehealth by a Contracted Health Care Provider